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Wednesday, June 27, 2018

Why do some people with autism have restricted interests and repetitive movements?

TheConversation: As a society, we’ve come a long way in our understanding of the
challenges people with autism face with social communication. But there
is a large gap in our understanding of another cluster of behaviours
that form part of an autism diagnosis: restrictive and repetitive
behaviours and interests (RRBs). These behaviours and interests appear to be made up of two
dimensions. The first is a pattern of overly regulated thinking:
obsessions and intense interests; a strong preference for maintaining
sameness; and ritualistic or habitual patterns of behaviour, such as
fiddling, or motor tics like blinking or throat clearing.
The second dimension is the rocking, twisting, flapping behaviour
often associated with early depictions of severe autism in the media.
The origin, or function, of the behaviour in each dimension appear to be different.
And while behaviours in the first dimension are particular to autism,
behaviours in the second are related to cognitive development and
sensory stimulation. They are common in typically developing
pre-school-age children but, when sustained past school age, may indicate an intellectual disability.

First dimension: thinking style

Autism is a behavioural diagnosis. This means it is diagnosed by
recognising the cluster of behaviours and the intensity and frequency of
them. However, to understand how restrictive and repetitive behaviours
and interests work, it’s important to understand the different thinking
style associated with autism.
Contrasted with neurotypical thinkers (those without autism), people
with autism have less abstract thought. They tend to be visual
processors of information, with less strength in linguistic coding, or
using language to explain their thoughts.
They are also less able to put themselves figuratively in other people’s shoes and guess what they’re thinking and feeling.
In effect, people with autism think of concrete stuff rather than the
abstract self-talk related to feelings. Without a conscious effort,
they’re less likely to generalise and have more difficulty recognising
like or similar situations. The impact is a thinking style that is not
concept-based but, rather, compartmentalised.
When faced with change, the difficulty people with autism have in
recognising like or similar experiences – out of their familiar thought
compartment – results in anxiety. This anxiety is not labelled and, as
an abstract concept, is not recognised.
The information that people with neurotypical patterns of thought
take for granted, such as how people around them may be feeling and the
link to expectations, is missing or dampened in people with autism.

Second dimension: pushy anxiety and getting locked in

Even though people with autism are more likely to think about
concrete stuff rather than abstract feelings, anxiety still exists and,
if not recognised, continues unmediated in the background.
Anxiety is a very pushy feeling. Think of the cave people and the
flight or fight response. In more recent times, think of the thing that
is created by deadlines and pushes you into activity when your threshold
level has been reached.
When we recognise anxiety, we can get action-oriented, or we can
choose to soothe the anxiety. If anxiety is operating in the background
unrecognised, it continues to push and gain momentum.
Read more:
Friday essay: moving autism on TV beyond the genius stereotype
For people with autism, this can push to obsessions and intense
interests or provide the fuel for extraordinary efforts to resist
change.
Excess anxiety fuel may also leak into habitual motor activity, such
as fiddling or motor tics, and ritualistic behaviours. Or it can push
the person into behaviours and thinking that operates to filter out the
noisy demands of the world, like obsessive behaviour and rituals.
This can turn into a cycle of increasing anxiety. Picture this
scenario: a new after-school routine triggers anxiety in a young person
with autism. They filter this out by becoming increasingly obsessed with
gaming. It’s clear they’re not responding to the demands of the new
after-school routine, so the pressure – and therefore, the anxiety –
increases. So too does the filtering (gaming). As this continues, the
young person is drifting further from the behaviour needed, while
getting locked in to the obsession.
This can be compounded by not recognising the feelings and
expectations of those around, prompting intense conversations and yet
more anxiety. Excess anxiety can cause restrictive and repetitive behaviours, which can cause social tension and more anxiety.Steven Wright/Shutterstock

Supportive structures

Emerging research shows the chance of getting locked into these behaviours increases when routine structures of work, school and family decline.
As the person’s world shrinks, the space left from these externally
imposed structures can be taken up with restrictive and repetitive
behaviours and interests. This is when the risk of getting “locked in”
to these filtering behaviours increases.
If anxiety levels are elevated, the externally imposed structures are
down, and the person has a history of getting locked in, it’s time to get expert intervention.
Specialist intervention can effectively reduce the person’s anxiety and
provide a scaffold of support by increasing their structured routine.